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  • Title: Underdiagnosis of Unilateral Spatial Neglect in stroke unit.
    Author: Puig-Pijoan A, Giralt-Steinhauer E, Zabalza de Torres A, Manero Borràs RM, Sánchez-Benavides G, García Escobar G, Pérez Enríquez C, Gómez-González A, Ois Á, Rodríguez-Campello A, Cuadrado-Godía E, Jiménez-Conde J, Peña-Casanova J, Roquer J.
    Journal: Acta Neurol Scand; 2018 Nov; 138(5):441-446. PubMed ID: 30058181.
    Abstract:
    OBJECTIVES: Unilateral spatial neglect (USN) is the incapacity to respond to stimuli presented opposite to a dysfunctional cerebral hemisphere. It is usually caused by non-dominant hemisphere lesions, leads to poorer prognosis and might be underdiagnosed. The objectives of the study were to ascertain the presence of USN in acute stroke patients and analyze the possible degree of underdiagnosis in a Stroke Unit. MATERIALS AND METHODS: Prospective study of consecutive non-dominant hemisphere stroke patients within a period of 21 months. "Line Bisection" and "Triangles Cancellation" tests were used for USN screening and "Circle Gap Detection Task" to confirm the USN. The results were compared with routine Stroke Unit assessment using the NIHSS to determine the possible degree of underdiagnosis. RESULTS: A total of 62 subjects, 38 women (61.29%), mean age of 74.05 (SD 10.5) years, were included. USN was diagnosed in 25 cases (40.3%) but 56% of them were not detected in routine evaluation using the NIHSS. CONCLUSIONS: Unilateral spatial neglect, a common cognitive deficit after acute stroke, is greatly underdiagnosed in routine Stroke Unit assessment. The use of simple USN-specific screening tools would improve diagnosis and therefore the possibility of implementing appropriate rehabilitation strategies.
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